The effectiveness of condoliase therapy for lumbar disc herniation
Introduction: The aim of this study was to investigate the frequency of significantly effective cases, where pain almost disappeared, and the associated factors in condoliase therapy for lumbar disc herniation (LDH). Methods: We enrolled 93 cases (61 males, 32 females, average age 45.6 years) that u...
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| Published in | Journal of Spine Research Vol. 15; no. 6; pp. 901 - 906 |
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| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society for Spine Surgery and Related Research
20.06.2024
一般社団法人 日本脊椎脊髄病学会 |
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| Online Access | Get full text |
| ISSN | 1884-7137 2435-1563 |
| DOI | 10.34371/jspineres.2024-0614 |
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| Abstract | Introduction: The aim of this study was to investigate the frequency of significantly effective cases, where pain almost disappeared, and the associated factors in condoliase therapy for lumbar disc herniation (LDH). Methods: We enrolled 93 cases (61 males, 32 females, average age 45.6 years) that underwent condoliase therapy for LDH with minimally follow-up of 1 year. Clinical evaluations, including Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for back pain and leg pain, and imaging assessments using MRI were conducted before and 1 year after the treatment. Cases with leg pain VAS≤1 cm at 1 year were considered significantly effective and were compared with non-significantly effective cases. Additionally, multivariate analysis was performed to identify risk factors.Results: Surgical treatment was subsequently required in 13 (14.0%) patients, and significantly effective in 49 (52.7%) patients. The rate of females and history of discectomy at the same level were significantly higher in non-significantly effective cases. Moreover, the symptom duration was significantly longer. Multivariate analysis identified symptom duration as independent associated factors.Conclusions: Chemonucleolysis with condoliase was significantly effective in 52.7% of cases. Significant therapeutic effects can be expected in cases with shorter symptom duration. |
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| AbstractList | Introduction: The aim of this study was to investigate the frequency of significantly effective cases, where pain almost disappeared, and the associated factors in condoliase therapy for lumbar disc herniation (LDH). Methods: We enrolled 93 cases (61 males, 32 females, average age 45.6 years) that underwent condoliase therapy for LDH with minimally follow-up of 1 year. Clinical evaluations, including Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for back pain and leg pain, and imaging assessments using MRI were conducted before and 1 year after the treatment. Cases with leg pain VAS≤1 cm at 1 year were considered significantly effective and were compared with non-significantly effective cases. Additionally, multivariate analysis was performed to identify risk factors.Results: Surgical treatment was subsequently required in 13 (14.0%) patients, and significantly effective in 49 (52.7%) patients. The rate of females and history of discectomy at the same level were significantly higher in non-significantly effective cases. Moreover, the symptom duration was significantly longer. Multivariate analysis identified symptom duration as independent associated factors.Conclusions: Chemonucleolysis with condoliase was significantly effective in 52.7% of cases. Significant therapeutic effects can be expected in cases with shorter symptom duration. Introduction: The aim of this study was to investigate the frequency of significantly effective cases, where pain almost disappeared, and the associated factors in condoliase therapy for lumbar disc herniation (LDH). Methods: We enrolled 93 cases (61 males, 32 females, average age 45.6 years) that underwent condoliase therapy for LDH with minimally follow-up of 1 year. Clinical evaluations, including Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for back pain and leg pain, and imaging assessments using MRI were conducted before and 1 year after the treatment. Cases with leg pain VAS≤1 cm at 1 year were considered significantly effective and were compared with non-significantly effective cases. Additionally, multivariate analysis was performed to identify risk factors.Results: Surgical treatment was subsequently required in 13 (14.0%) patients, and significantly effective in 49 (52.7%) patients. The rate of females and history of discectomy at the same level were significantly higher in non-significantly effective cases. Moreover, the symptom duration was significantly longer. Multivariate analysis identified symptom duration as independent associated factors.Conclusions: Chemonucleolysis with condoliase was significantly effective in 52.7% of cases. Significant therapeutic effects can be expected in cases with shorter symptom duration. はじめに:本研究の目的は,腰椎椎間板ヘルニアに対するコンドリアーゼ治療において疼痛がほぼ消失した著効例の頻度とその関連因子を調査することとした.対象と方法:腰椎椎間板ヘルニアに対してコンドリアーゼ治療を行い,1年以上経過観察可能であった93例(男性61例,女性32例,平均年齢45.6歳)を対象とした.臨床評価としてODI,VAS(腰痛,下肢痛)を,画像評価としてMRIを投与前,投与後1年時に評価した.1年時に下肢痛VAS≦1 cmを著効例とし,非著効例と比較検討した.また,多変量解析を行い危険因子を同定した.結果:手術移行例は13例(14.0%)で,著効例は49例(52.7%)であった.非著効例では,女性,同一椎間手術歴の割合が有意に高かった.また,罹病期間が有意に長かった.多変量解析にて罹病期間が独立した関連因子であった.結語:コンドリアーゼによる髄核融解術は52.7%に著効した.短い罹病期間の症例では大きな治療効果が期待できる. |
| Author | Yamato, Yu Arima, Hideyuki Yamada, Tomohiro Oe, Shin Matsuyama, Yukihiro Watanabe, Yuh Yoshida, Go Banno, Tomohiro Kurosu, Kenta Hasegawa, Tomohiko Ide, Koichiro |
| Author_FL | 山田 智裕 井出 浩一郎 渡邉 悠 黒須 健太 吉田 剛 Hasegawa Tomohiko 有馬 秀幸 大江 慎 松山 幸弘 坂野 友啓 大和 雄 |
| Author_FL_xml | – sequence: 1 fullname: 坂野 友啓 – sequence: 2 fullname: Hasegawa Tomohiko – sequence: 3 fullname: 大和 雄 – sequence: 4 fullname: 吉田 剛 – sequence: 5 fullname: 有馬 秀幸 – sequence: 6 fullname: 大江 慎 – sequence: 7 fullname: 井出 浩一郎 – sequence: 8 fullname: 山田 智裕 – sequence: 9 fullname: 黒須 健太 – sequence: 10 fullname: 渡邉 悠 – sequence: 11 fullname: 松山 幸弘 |
| Author_xml | – sequence: 1 fullname: Ide, Koichiro organization: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine – sequence: 1 fullname: Yamada, Tomohiro organization: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine – sequence: 1 fullname: Arima, Hideyuki organization: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine – sequence: 1 fullname: Banno, Tomohiro organization: Division of Surgical care Morimachi, Hamamatsu University School of Medicine – sequence: 1 fullname: Kurosu, Kenta organization: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine – sequence: 1 fullname: Yamato, Yu organization: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine – sequence: 1 fullname: Watanabe, Yuh organization: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine – sequence: 1 fullname: Hasegawa, Tomohiko organization: Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine – sequence: 1 fullname: Oe, Shin organization: Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine – sequence: 1 fullname: Matsuyama, Yukihiro organization: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine – sequence: 1 fullname: Yoshida, Go organization: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine |
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| References | 4) Nakajima H, Kubota A, Maezawa Y, et al: Short-Term Outcome and Predictors of Therapeutic Effects of Intradiscal Condoliase Injection for Patients with Lumbar Disc Herniation. Spine surgery and related research. 2021; 5 (4): 264-271. eng 5) Inoue M, Sainoh T, Kojima A, et al: Efficacy and Safety of Condoliase Disc Administration as a New Treatment for Lumbar Disc Herniation. Spine surgery and related research. 2022; 6 (1): 31-37. eng 10) Chiba K, Matsuyama Y, Seo T, et al: Condoliase for the Treatment of Lumbar Disc Herniation: A Randomized Controlled Trial. Spine. 2018; 43 (15): E869-E876. eng 3) Ishibashi K, Fujita M, Takano Y, et al: Chemonucleolysis with Chondroitin Sulfate ABC Endolyase for Treating Lumbar Disc Herniation: Exploration of Prognostic Factors for Good or Poor Clinical Outcomes. Medicina (Kaunas, Lithuania). 2020; 56 (11). eng 2) Okada E, Suzuki S, Nori S, et al: The effectiveness of chemonucleolysis with condoliase for treatment of painful lumbar disc herniation. J Orthop Sci. 2021; 26 (4): 548-554. eng 6) Hirai T, Takahashi T, Tanaka T, et al: Intradiscal Injection with Condoliase (Chondroitin Sulfate ABC Endolyase) for Painful Radiculopathy Caused by Lumbar Disc Herniation. Spine surgery and related research. 2022; 6 (3): 252-260 1) Banno T, Hasegawa T, Yamato Y, et al: Clinical outcome of condoliase injection treatment for lumbar disc herniation: Indications for condoliase therapy. J Orthop Sci. 2021; 26 (1): 79-85. eng 9) Banno T, Hasegawa T, Yamato Y, et al: Disc degeneration could be recovered after chemonucleolysis with condoliase.-1 year clinical outcome of condoliase therapy. J Orthop Sci. 2022; 27 (4): 767-773. eng 7) Oshita Y, Matsuyama D, Sakai D, et al: Multicenter Retrospective Analysis of Intradiscal Condoliase Injection Therapy for Lumbar Disc Herniation. Medicina (Kaunas, Lithuania). 2022; 58 (9). eng 8) Takeuchi S, Hanakita J, Takahashi T, et al: Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation. Medicina (Kaunas, Lithuania). 2022; 58 (12). eng |
| References_xml | – reference: 4) Nakajima H, Kubota A, Maezawa Y, et al: Short-Term Outcome and Predictors of Therapeutic Effects of Intradiscal Condoliase Injection for Patients with Lumbar Disc Herniation. Spine surgery and related research. 2021; 5 (4): 264-271. eng – reference: 10) Chiba K, Matsuyama Y, Seo T, et al: Condoliase for the Treatment of Lumbar Disc Herniation: A Randomized Controlled Trial. Spine. 2018; 43 (15): E869-E876. eng – reference: 1) Banno T, Hasegawa T, Yamato Y, et al: Clinical outcome of condoliase injection treatment for lumbar disc herniation: Indications for condoliase therapy. J Orthop Sci. 2021; 26 (1): 79-85. eng – reference: 3) Ishibashi K, Fujita M, Takano Y, et al: Chemonucleolysis with Chondroitin Sulfate ABC Endolyase for Treating Lumbar Disc Herniation: Exploration of Prognostic Factors for Good or Poor Clinical Outcomes. Medicina (Kaunas, Lithuania). 2020; 56 (11). eng – reference: 6) Hirai T, Takahashi T, Tanaka T, et al: Intradiscal Injection with Condoliase (Chondroitin Sulfate ABC Endolyase) for Painful Radiculopathy Caused by Lumbar Disc Herniation. Spine surgery and related research. 2022; 6 (3): 252-260 – reference: 7) Oshita Y, Matsuyama D, Sakai D, et al: Multicenter Retrospective Analysis of Intradiscal Condoliase Injection Therapy for Lumbar Disc Herniation. Medicina (Kaunas, Lithuania). 2022; 58 (9). eng – reference: 2) Okada E, Suzuki S, Nori S, et al: The effectiveness of chemonucleolysis with condoliase for treatment of painful lumbar disc herniation. J Orthop Sci. 2021; 26 (4): 548-554. eng – reference: 8) Takeuchi S, Hanakita J, Takahashi T, et al: Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar Disc Herniation. Medicina (Kaunas, Lithuania). 2022; 58 (12). eng – reference: 5) Inoue M, Sainoh T, Kojima A, et al: Efficacy and Safety of Condoliase Disc Administration as a New Treatment for Lumbar Disc Herniation. Spine surgery and related research. 2022; 6 (1): 31-37. eng – reference: 9) Banno T, Hasegawa T, Yamato Y, et al: Disc degeneration could be recovered after chemonucleolysis with condoliase.-1 year clinical outcome of condoliase therapy. J Orthop Sci. 2022; 27 (4): 767-773. eng |
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| SubjectTerms | chemonucleolysis condoliase lumbar disc herniation コンドリアーゼ 化学的髄核融解術 腰椎椎間板ヘルニア |
| Title | The effectiveness of condoliase therapy for lumbar disc herniation |
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